Leaving the NHS: Myths, Reality, and What Actually Matters

Introduction

I can still remember vividly how I felt when I told people I was leaving the NHS. The 'why are you leaving?', the raised eyebrows, the 'what about your holidays/ pension' questions. And alongside this my fear of change, I'd been turning up to the same place of work for well over 5 years. What would somewhere new look like and feel like? Would it be more strict or scary? 

Now, having made the move and experienced both worlds, I want to share what actually happened so that if you're in a position where you're wondering what's next or thinking that the NHS isn't for you any more you've heard a real story. 

The Myths that nearly stopped me

Myth 1: You'll have to work harder in the private sector

Let me be clear: I worked in the same way in both the NHS and Private sector. If you're going to work hard, you'll do it wherever you are. The standards in the private sector can feel higher at times, but because you're not distracted by 'firefighting' that's easier to achieve. I found myself working with the same level of commitment, just in a different context often with a little more thinking time.

Myth 2: You'll lose all the good benefits

This was a big one everyone talks about. The perks of the NHS pension,  the generous annual leave and the sick pay policies everyone envies. However, if you find the right employer you'll get benefits which get close to matching these benefits. You can choose your pension contribution, your salary is usually higher, and there other benefits such as private health insurance or death in service insurance that you don't get in the NHS.  Yes, there are differences in the details, particularly around things like maternity leave and long-term sickness provision, and these should be considered, but make sure you're considering them in relation to other pay, or flexible working arrangements. 

Myth 3: You're abandoning the NHS ethos

I did worry about this a lot. The guilt trip. The suggestion that choosing private sector work means you are a bad person, who wants to make money out of the NHS. This myth is perhaps the most damaging because I don't think it's true. Those working in the private sector in consultancy care just as much about the NHS, and do their work to try and help those working in it. 

What Actually Was Different

While the myths were largely overblown, there were genuine differences I hadn't fully anticipated.

The pace and rhythm of work changed in ways I didn't expect. I found myself with more thinking time and that took a lot of time to adjust to. There were fewer crises, less firefighting, fewer dramatic situations that pulled me in ten directions at once. For months after leaving I kept waiting for the crisis to happen, and it never did in quite the same way. Eventually, I realised that they way things worked were just different now. 

The organisational culture operated differently. Decision-making processes are very different outside of the NHS and actually you may have more opportunity to make a decision. The way of communicating will be different, and the way teams functioned all had their own approach. Neither better nor worse, just different. Learning to navigate this new culture took time and conscious effort.

The benefits package details did have some variations. While the day-to-day holiday allowance and work-life balance were comparable, I was fortunate not to need extended sick leave during my time in the private sector. This is an area where the NHS safety net is genuinely more robust. Similarly, maternity leave provisions can differ significantly. These aren't dealbreakers, but they're worth understanding before you make your decision.

What This Move Taught Me

Making this transition gave me something invaluable: perspective and learning. I told myself when leaving that I could always go back, and that learning outside of the NHS would be beneficial for this. I have experienced a number of different ways of working, different organisational cultures (including working in much smaller organisations), and seen different approaches to healthcare delivery, which I know means if I return I will have new and different skills from those if I had stayed. 

By taking the plunge, I removed all the mystery and the fear, and applied what I've always done. The mantra that 'if it doesn't work, you can always go back'. But the time has actually helped me to learn what I valued most in my work environment and I have discovered what aspects of NHS culture I genuinely missed and which ones I was happy to leave behind.

Perhaps most importantly, I learned that this decision wasn't permanent or irreversible. Knowing I could always return to the NHS if things didn't work out gave me the confidence to explore. This safety net transformed what felt like a terrifying leap into a manageable experiment.

If You're Considering the Move

Here's what I wish someone had told me when I was weighing this decision:

It's okay to be curious. Wondering about the private sector doesn't make you disloyal or money-hungry or any of the other judgmental labels people might throw around. It makes you someone who wants to understand their options.

You don't have to know the answer before you try. I didn't have complete clarity about whether I wanted to leave the NHS permanently. I just knew I wanted to experience something different. That was enough.

The decision isn't as binary as it seems. Healthcare careers are long. You can move between sectors multiple times throughout your working life. Each experience adds to your professional toolkit and helps you understand what matters most to you.

Focus on what you're moving toward, not just what you're leaving. I was fortunate that my private sector roles offered me opportunities to develop different skills and work in different ways. Think about what you want to gain from a move, not just what you're trying to escape.

Talk to people who've actually done it. Not people who have opinions about it. People who've lived it. Their experiences won't be identical to yours, but they'll be grounded in reality rather than assumption.

The Bottom Line

Making the move from NHS to private sector was one of the best professional decisions I made, but not for the reasons people assume. It wasn't about better pay or escaping the pressures of the NHS. It was about giving myself permission to explore, to experience different ways of working, learn new skills and to gain clarity about what I truly wanted from my career.

The myths about this transition are powerful, and they keep talented people stuck in situations that no longer serve them. The reality is far more nuanced and far less scary than the stories we tell ourselves.

If you're considering this move, I'm here to support you. As a coach who's been through this transition, I understand the concerns, the guilt, the practical worries, and the excitement of possibility. You don't have to navigate this alone, and you don't have to have all the answers before you take the first step.

The question isn't whether the NHS or private sector is "better." The question is: what is better for you right now.